I have written a book on the politics of autism policy. Building on this research, this blog offers insights, analysis, and facts about recent events. If you have advice, tips, or comments, please get in touch with me at jpitney@cmc.edu

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Thursday, February 3, 2011

Regional Centers and Negotiated Rates

The state can pay wildly varying rates, up to $250,000 a year per person, to fulfill its legal obligation to care for developmentally disabled people, despite laws meant to cap the costs of such programs.

Service providers can negotiate rates higher than the caps by proving they serve clients with special needs that require extra services, such as overnight care and more medical attention.

The public, however, can't see the final amounts paid or how they were negotiated.

California distributes funding for the care of developmentally disabled people to 21 nonprofit regional centers, which aren't subject to disclosure laws regulating public agencies.

The centers don't provide the care themselves, but contract with a system of vendors for a range of services – everything from homes for people with schizophrenia to day programs where clients receive therapy and skill development training.

The state has capped the rates it pays vendors, but regional centers have increasingly allowed service providers to skirt those caps using a complex system of criteria.

...

"I think the majority of negotiated-rate programs I've experienced, they're not providing anything different than what a regular vendor provides," said Boyd Bradshaw, who leads a statewide coalition of 1,200 service providers.

"Our concern is that we're creating a dual system, where you have normal residential-care vendors and consumers in these homes that are basically unable to maintain their services because they're underfunded."

The state's third largest regional center, in Orange County, has avoided opening virtually any negotiated-rate homes while caring for some 17,000 people, said Executive Director Larry Landauer.

The center adds services from its regular budget when people need more care and returns to a normal service level when the need passes, he said.

"If someone has a bad couple of weeks, we add that program," Landauer said. "I prefer this model, that on a case-by-case basis, we're able to meet the person's needs."

All providers, regardless of the rates they set, will likely find themselves in the same boat this year, as the biggest-ever budget cuts to hit the regional centers loom, Landauer said.

"All I know is whatever is put in front of Orange County, we'll try to find a way to work with what we have," he said. "But it's getting harder."